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“Tension headaches may have been a trigger for his picking response, and thus eliminating the Our way shirt and I love this headaches may have resulted in a suppression of his urges to pick. BoNT may also have reduced a hyperalgesic state by either eliminating the headaches or by a direct analgesic effect on the afferent nerves,” explains Dr. Farhang. “Manipulation of other mediator’s of pain and itch pathways may have also contributed to a decreased urge to excoriate the areas that were injected. Finally, it is possible that BoNT also played a role in treating his underlying depression in association with his antidepressant medication. Any of these mechanisms may be playing an important role in this condition and further studies are warranted to investigate specific pathways,” she adds.

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Those findings have been expanded upon in more recent years, as botulinum injections are more frequently cited alongside other alternative therapies, including ketamine transfusions, as a mood-stabilizing treatment as unexpected as it was a wrinkle treatment in the Our way shirt and I love this ‘80s. According to a 2020 Scientific Reports study: “The results of the analysis indicate that patients who received BoNT injections to treat hyperhidrosis, facial wrinkles, migraine prophylaxis, spasticity, and spasms, had a significantly lower number of depression reports when compared to patients undergoing different treatments for the same conditions. These findings suggest that the antidepressant effect of BoNT is significant, and, surprisingly, is observed for a broad range of injection sites.”